ABSTRACT
LOWER EXTREMITY Introduction Atherosclerotic peripheral arterial disease (PAD) is highly prevalent, present in at least 8 to 12 million adults living in the United States. As the population ages, its incidence will undoubtedly continue to increase (1). PAD can have a major impact on quality of life, and it remains a significant source of morbidity and mortality. Because atherosclerosis is a systemic process, patients with PAD are at high risk of coronary and cerebrovascular ischemic events, and thus the diagnosis of PAD has strong prognostic implications. Over the last 10 years, there has been an exponential growth in the number of endovascular repair procedures for lower extremity claudication and critical limb ischemia. The procedures have grown in almost every subspecialty including cardiology, vascular surgery, and interventional radiology. Advances in technology have allowed the development of more effective endovascular approaches that has prompted a swing away from open surgical repair. This being accepted we must continue to recognize which modality is the best suited to assure the lowest risk procedure that result in the most durable outcome.
